Hdl Handle:
http://hdl.handle.net/10675.2/694
Title:
Chlamydia trachomatis infection and risk of cervical intraepithelial neoplasia
Authors:
Lehtinen, Matti; Ault, Kevin A; Lyytikainen, Erika; Dillner, Joakim ( 0000-0001-8588-6506 ) ; Garland, Suzanne M; Ferris, Daron G.; Koutsky, Laura A; Sings, Heather L; Lu, Shuang; Haupt, Richard M; Paavonen, Jorma
Abstract:
Objectives: High-risk human papillomavirus (hrHPV) is the primary cause of cervical cancer. As Chlamydia trachomatis is also linked to cervical cancer, its role as a potential co-factor in the development of cervical intraepithelial neoplasia (CIN) grade 2 or higher was examined.; Methods: The placebo arms of two large, multinational, clinical trials of an HPV6/11/16/18 vaccine were combined. A total of 8441 healthy women aged 15â 26â years underwent cervicovaginal cytology (Papanicolaou (Pap) testing) sampling and C trachomatis testing at day 1 and every 12 months thereafter for up to 4 years. Protocol-specified guidelines were used to triage participants with Pap abnormalities to colposcopy and definitive therapy. The main outcome measured was CIN.; Results: At baseline, 2629 (31.1%) tested positive for hrHPV DNA and 354 (4.2%) tested positive for C trachomatis. Among those with HPV16/18 infection (n=965; 11.4%) or without HPV16/18 infection (n=7382, 87.5%), the hazard ratios (HRs) associated with development of any CIN grade 2 according to baseline C trachomatis status were 1.82 (95% CI: 1.06 to 3.14) and 1.74 (95% CI 1.05 to 2.90), respectively. The results were comparable when only the 12 most common hrHPV infections were considered, but the excess risk disappeared when the outcome was expanded to include CIN grade 3 or worse.; Conclusion: Further studies based on larger cohorts with longitudinal follow-up in relation to the C trachomatis acquisition and a thorough evaluation of temporal relationships of infections with hrHPV types, C trachomatis and cervical neoplasia are needed to demonstrate whether and how in some situations C trachomatis sets the stage for cervical carcinogenesis.; Trial registration: NCT00092521 and NCT00092534.
Citation:
Sex Transm Infect. 2011 Aug 6; 87(5):372-376
Issue Date:
6-Apr-2011 ; 6-Aug-2011
URI:
http://hdl.handle.net/10675.2/694
DOI:
10.1136/sti.2010.044354
PubMed ID:
21471141
PubMed Central ID:
PMC3252607
Type:
Article
ISSN:
1472-3263
Appears in Collections:
Department of Obstetrics and Gynecology: Faculty Research and Presentations

Full metadata record

DC FieldValue Language
dc.contributor.authorLehtinen, Mattien_US
dc.contributor.authorAult, Kevin Aen_US
dc.contributor.authorLyytikainen, Erikaen_US
dc.contributor.authorDillner, Joakimen_US
dc.contributor.authorGarland, Suzanne Men_US
dc.contributor.authorFerris, Daron G.en_US
dc.contributor.authorKoutsky, Laura Aen_US
dc.contributor.authorSings, Heather Len_US
dc.contributor.authorLu, Shuangen_US
dc.contributor.authorHaupt, Richard Men_US
dc.contributor.authorPaavonen, Jormaen_US
dc.date.accessioned2012-10-26T16:29:35Z-
dc.date.available2012-10-26T16:29:35Z-
dc.date.issued2011-04-6en_US
dc.date.issued2011-08-6en_US
dc.identifier.citationSex Transm Infect. 2011 Aug 6; 87(5):372-376en_US
dc.identifier.issn1472-3263en_US
dc.identifier.pmid21471141en_US
dc.identifier.doi10.1136/sti.2010.044354en_US
dc.identifier.urihttp://hdl.handle.net/10675.2/694-
dc.description.abstractObjectives: High-risk human papillomavirus (hrHPV) is the primary cause of cervical cancer. As Chlamydia trachomatis is also linked to cervical cancer, its role as a potential co-factor in the development of cervical intraepithelial neoplasia (CIN) grade 2 or higher was examined.en_US
dc.description.abstractMethods: The placebo arms of two large, multinational, clinical trials of an HPV6/11/16/18 vaccine were combined. A total of 8441 healthy women aged 15â 26â years underwent cervicovaginal cytology (Papanicolaou (Pap) testing) sampling and C trachomatis testing at day 1 and every 12 months thereafter for up to 4 years. Protocol-specified guidelines were used to triage participants with Pap abnormalities to colposcopy and definitive therapy. The main outcome measured was CIN.en_US
dc.description.abstractResults: At baseline, 2629 (31.1%) tested positive for hrHPV DNA and 354 (4.2%) tested positive for C trachomatis. Among those with HPV16/18 infection (n=965; 11.4%) or without HPV16/18 infection (n=7382, 87.5%), the hazard ratios (HRs) associated with development of any CIN grade 2 according to baseline C trachomatis status were 1.82 (95% CI: 1.06 to 3.14) and 1.74 (95% CI 1.05 to 2.90), respectively. The results were comparable when only the 12 most common hrHPV infections were considered, but the excess risk disappeared when the outcome was expanded to include CIN grade 3 or worse.en_US
dc.description.abstractConclusion: Further studies based on larger cohorts with longitudinal follow-up in relation to the C trachomatis acquisition and a thorough evaluation of temporal relationships of infections with hrHPV types, C trachomatis and cervical neoplasia are needed to demonstrate whether and how in some situations C trachomatis sets the stage for cervical carcinogenesis.en_US
dc.description.abstractTrial registration: NCT00092521 and NCT00092534.en_US
dc.rights© 2011, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.en_US
dc.subjectEpidemiologyen_US
dc.subject1506en_US
dc.titleChlamydia trachomatis infection and risk of cervical intraepithelial neoplasiaen_US
dc.typeArticleen_US
dc.identifier.pmcidPMC3252607en_US
dc.contributor.corporatenameDepartment of Obstetrics and Gynecology-

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